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Commonly called "bupe" on the street, or by its brand name, Suboxone, the medication is used in combination with other therapy to treat opioid use disorder.

Administered as a film on the tongue, or as a tablet absorbed under the tongue, the medication begins relieving withdrawal symptoms within 10 to 15 minutes, and can prevent a patient from experiencing a "high" for 24 to 36 hours.

“Buprenorphine is a critical medication that doesn't just bring folks into recovery — it can also dampen the devastating effects of opioid withdrawal,” Elnahal said. “That's why equipping our EMS professionals with this drug is so important."

The commissioner's directive comes as welcome news in Camden, where Cooper University Health Care's emergency medical crews administered naloxone more than 1,200 times last year, often to see the same patients overdose a few hours later.

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Cooper University Hospital EMT Tyler Hannan wears protective gear as he holds a syringe of naloxone in this file photo.(Photo: Chris LaChall/Staff Photographer)

Cooper's emergency room doctors can already prescribe three days' worth of buprenorphine and refer patients to recovery coaches and outpatient resources, such as the health system's addiction clinic, CAMcare, and Project H.O.P.E.

Often, revived patients refuse further treatment before reaching the hospital. Cooper paramedics reported they were frustrated and burned out after reviving the same patients, day in and day out, and suggested the need for more solutions.

The city is "ground zero" for South Jersey's opioid crisis, said Dr. Gerard Carroll, a paramedic and medical director for Cooper EMS. As vice chairman of the state health department's Mobile Intensive Care Unit Advisory Committee, Carroll made a case for allowing paramedics to carry buprenorphine. The committee endorsed the plan before it was approved by the commissioner.

"This is the next big step we’d like to take in trying to get our patients into treatment, to stop shooting up, (get) off the street and begin to reclaim their lives," Carroll said.

About a year ago, with funding help from the Centers for Disease Control and Prevention, Cooper began experimenting with solutions for its emergency crews. They started by training EMTs and paramedics on how to combat compassion fatigue and stigma, how to communicate with people in active addiction, and how to steer them toward treatment.

Cooper added an outreach paramedic to work on the street, and two EMS physicians began carrying buprenorphine in the field to offer revived patients a start toward long-term treatment.

Rick Rohrbach, Cooper's EMS director for air and ground services, said his staff embraced the new approach. The health system will begin equipping paramedics with buprenorphine as early as next month.

"It’s amazing to see how they’ve really engaged in this, how excited they are, because it is something newer for them to not to be in the '911' moment, but to be more of the solution to this problem," Rohrbach said.

Other health systems are holding off, including Virtua, Inspira and AtlantiCare, which together provide paramedic coverage for the rest of South Jersey.

AtlantiCare takes a different approach to reviving overdosed patients, administering only enough naloxone to get the patient breathing and able to hold open his own airway, but not awake enough to go into withdrawal and refuse a trip to the hospital and its recovery resources, explained Dr. Thomas Brabson, who heads AtlantiCare's emergency services. The health system provides paramedic coverage primarily for Atlantic and Cape May counties.

"Once the person refuses treatment, now you've potentially lost the opportunity to get them plugged into after-care," Brabson said.

Ed Brazell, a Gloucester County recovery coach and trainer, wondered what might happen to patients after paramedics administer buprenorphine. Would they go to the hospital and its recovery coaches, or return to the streets?

"It's kind of a catch-22 thing," he said.

Cooper's emergency crews aren't sure yet how patients will respond, said Carroll. But he believes it's a way to shorten the path to treatment.

"When you have an EMS unit, you have two paramedics who have nothing else in the world to do right now but focus on your care," Carroll said. "Can we help you with those symptoms before you can’t think straight, before you’re so dope-sick that you just need to run and do whatever you can to shoot up again?

"We don’t know the answer to that, but that’s part of this project is to find out."